The Couch as Icon by Ahron Friedberg & Louis Linn

Click here to read: “The Couch as Icon” by Ahron Friedberg & Louis Linn originally published in The Psychoanalytic Review, volume 99, No. 1, February 2012.

The couch has always been an integral part of psychoanalytic practice. It has even become a cultural icon representing psychoanalysis itself. However, minimal evidence exists in the psychoanalytic literature that using the couch is necessary or even necessarily helpful to establish a psychoanalytic process and conduct an analysis. Furthermore, it can potentially be harmful to patients such as those who have experienced early loss and trauma or who have significant ego organizational prob- lems. Therefore, the use of the couch per se does not seem well suited as a defining criterion of psychoanalysis. To the extent that it may be clinically valuable, the use of the couch should be more carefully con- sidered and critically examined.

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2 Comments on “The Couch as Icon by Ahron Friedberg & Louis Linn”

  1. Horst Kächele Says:

    Andreasen, N., O’Leary, D., Cizadlo, T., Arndt, S., Rezai, K., Watkins, G., . . . Hichwa, R. (1995). Remembering the past: two facets of episodic memory explored with positron emission tomography. Am J Psychiatry, 152(11), 1576-1585.

    at least one could have cited this true experimental study which we also did not mention in favor of the recumbent position; it may be useful to open memory system
    , whether is is good for clinical outcome is a different issue
    horst kaechele

  2. Nathan SZajnberg, MD Says:

    very pleased that this paper is publsihed on, where ideas can be reconsidered by colleagues.

    The second footnote from Gabbard and Ogden captures my experiences: I find I work in a freer state of mind when my adult patients are using the couch. I see teens and children also, so face-to-face is quite present in my practice with them. I learn how much they scan my body movements and facial expressions during the work. For my adult patients, I find I can focus better when not being observed.

    There is a lively literature on whether borderline patients can benefit from using the couch. Part of the challenge is knowing what is borderline.

    Finallly, the papers emphasis on analysis (from the Greek) reminds me of Laplanches distinction between analysis and therapy.

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